Authors
Mrykhin G.A.2, Groshilin V.S.2, Zhernosenco A.O.1, Kuznecov V.D.2, Vardanyan E.V.2
1 Pirogov National Medical and Surgical Center, Moscow
2 Rostov State Medical University, Rostov-on-Don
Abstract
Backgraund: Fistulas in anorectal region are an actual problem of modern coloproctology. High recurrence rate of fistulas in ano reach 25–30 percent. So problem of treatment fistulas in ano is very acute.
Objective. To evaluate the effectiveness of the original minimally invasive method of treatment of rectal fistulas.
Materials and methods. A prospective cohort study of the treatment of patients of three groups of patients was conducted. The first group is an original technique based on the use of video–assisted treatment of the fistula according to the original technique in combination with the placement of a plug-siton (patent Russian Federation №2795536) — (n = 27), group II — ligation of the fistula in the intersphincter space (LIFT) — (n = 32), group III — laser coagulation of the fistula according to the method FILAC — (n = 28).
Results. During the treatment in all three groups of patients, satisfactory results were obtained in 93.1%. Relapse of the disease occurred in 2 patients of group I (7.40%), in 1 patient of group II (3.15%), in 3 patients of group III (10.70%) at p = 0,001. Fecal incontinence and gas were not detected in patients of all study groups.
Conclusion. We consider the main advantage of minimally invasive methods to be their safety regarding the development of anal incontinence. The original method of fistula treatment developed by us is comparable in its effectiveness with other minimally invasive techniques, however, it has an advantage due to the effective obturation of the fistula course and the creation of a biological matrix for the regeneration of anal sphincters.
Keywords: fistula-in-ano, video-assisted treatment of fistulas, sphincter-sparing minimally invasive technologies.
References
1. ZHanbyrbaj BK, Kosherbaeva LK, Abdraimov ZHO, et al. Svishchi pryamoj kishki. Vestnik Kazahskogo nacional’nogo medicinskogo universiteta. 2021; 1: 165-169. (In Russ.)
2. Shelygin YUA, Vasil’ev SV, Veselov AV, et al. Svishch zadnego prohoda. Koloproktologiya. 2020; 3(73): 10-25. (In Russ.) doi: 10.33878/ 2073-7556-2020-19-3-10-25.
3. Atroshchenko AO, Kiselev DO, Pozdnyakov SV, et al. Evolyuciya lecheniya svishchej pryamoj kishki: ot rezekcionnyh metodov k lazernoj ablacii FiLaC®. Tazovaya hirurgiya i onkologiya. 2021; 11(1): 35-41. (In Russ.) doi: 10.17650/2686-9594-2021-11-1-35-41.
4. Kotenko KV, Kovalev SA, Bedzhanyan AL, et al. Sovremennye hirurgicheskie tekhnologii v lechenii bol’nyh hronicheskim paraproktitom. Hirurgiya. ZHurnal im. N.I. Pirogova. 2022; 4: 80-85. (In Russ.) doi: 10.17116/ hirurgia202204180.
5. Mryhin GA, Groshilin VS, Bakulyarov MYU, et al. Effektivnost’ maloinvazivnogo sfinkterosberigayushchego sposoba lecheniya svishchej pryamoj kishki. Sovremennye problemy nauki i obrazovaniya. 2021; 6: 147. (In Russ.) doi: 10.17513/spno.31289.
6. Kostarev IV, Kiselev DO, Blagodarnyj LA, et al. Sravnitel’nyj analiz rezul’tatov lecheniya trans- i ekstrasfinkternyh svishchej pryamoj kishki metodom termoobliteracii svishchevogo hoda s pomoshch’yu diodnogo lazera ili monopolyarnoj elektrokoagulyacii. Vestnik hirurgii im. I.I. Grekova. 2020; 179(4): 36-43. (In Russ.) doi: 10.24884/0042-4625-2020-179-4-36-43.
7. Vasil’ev SV, Nedozimovanyj AI, Popov DE, et al. Opyt kombinirovannogo ispol’zovaniya lazernoj koagulyacii v sochetanii s metodikoj LIFT pri lechenii transsfikternyh svishchej pryamoj kishki. Koloproktologiya. 2021; 2(76): 35-41. (In Russ.) doi: 10.33878/2073-7556-2021-20-2-35-41.
8. Kazarezov OV. Pervye rezul’taty ispol’zovaniya lazernoj termoobliteracii svishchevogo hoda (FILAC) v ambulatornom lechenii svishchej pryamoj kishki. Koloproktologiya. 2020; № S1(73): 16. (In Russ.)
